SORA

Advancing, promoting and sharing knowledge of health through excellence in teaching, clinical practice and research into the prevention and treatment of illness

Changes in central venous saturation after major surgery, and association with outcome.

Pearse, R; Dawson, D; Fawcett, J; Rhodes, A; Grounds, RM; Bennett, ED (2005) Changes in central venous saturation after major surgery, and association with outcome. Crit Care, 9 (6). R694-R699. ISSN 1466-609X https://doi.org/10.1186/cc3888
SGUL Authors: Rhodes, Andrew

[img]
Preview
PDF Published Version
Available under License Creative Commons Attribution.

Download (222kB) | Preview

Abstract

INTRODUCTION: Despite recent interest in measurement of central venous oxygen saturation (ScvO2), there are no published data describing the pattern of ScvO2 changes after major general surgery or any relationship with outcome. METHODS: ScvO2 and other biochemical, physiological and demographic data were prospectively measured for 8 hours after major surgery. Complications and deaths occurring within 28 days of enrollment were included in the data analysis. Independent predictors of complications were identified with the use of logistic regression analysis. Optimum cutoffs for ScvO2 were identified by receiver operator characteristic analysis. RESULTS: Data from 118 patients was analysed; 123 morbidity episodes occurred in 64 these patients. There were 12 deaths (10.2%). The mean +/- SD age was 66.8 +/- 11.4 years. Twenty patients (17%) underwent emergency surgery and 77 patients (66%) were male. The mean +/- SD P-POSSUM (Portsmouth Physiologic and Operative Severity Score for the enUmeration of Mortality and morbidity) score was 38.6 +/- 7.7, with a predicted mortality of 16.7 +/- 17.6%. After multivariate analysis, the lowest cardiac index value (odds ratio (OR) 0.58 (95% confidence intervals 0.37 to 0.9); p = 0.018), lowest ScvO2 value (OR 0.94 (0.89 to 0.98); p = 0.007) and P-POSSUM score (OR 1.09 (1.02 to 1.15); p = 0.008) were independently associated with post-operative complications. The optimal ScvO2 cutoff value for morbidity prediction was 64.4%. In the first hour after surgery, significant reductions in ScvO2 were observed, but there were no significant changes in CI or oxygen delivery index during the same period. CONCLUSION: Significant fluctuations in ScvO2 occur in the immediate post-operative period. These fluctuations are not always associated with changes in oxygen delivery, suggesting that oxygen consumption is also an important determinant of ScvO2. Reductions in ScvO2 are independently associated with post-operative complications.

Item Type: Article
Additional Information: © Pearse et al.; licensee BioMed Central Ltd. 2005 This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Aged, Female, Humans, London, Male, Multivariate Analysis, Outcome Assessment (Health Care), Oxygen, Postoperative Complications, Prospective Studies, Reference Values, Sensitivity and Specificity, Survival Analysis, Veins, Veins, Humans, Postoperative Complications, Oxygen, Multivariate Analysis, Sensitivity and Specificity, Survival Analysis, Prospective Studies, Reference Values, Aged, Outcome Assessment (Health Care), London, Female, Male, Science & Technology, Life Sciences & Biomedicine, Critical Care Medicine, General & Internal Medicine, CRITICAL CARE MEDICINE, OXYGEN-SATURATION, INTENSIVE-CARE, SHOCK, EMERGENCY, TRANSPORT, DELIVERY, PATTERNS, FAILURE, BLOOD, 11 Medical And Health Sciences, Emergency & Critical Care Medicine
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) > Cell Sciences (INCCCS)
Journal or Publication Title: Crit Care
ISSN: 1466-609X
Language: eng
Dates:
DateEvent
8 November 2005Published
30 September 2005Accepted
Publisher License: Creative Commons: Attribution 2.0
PubMed ID: 16356220
Web of Science ID: WOS:000235514400017
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/110379
Publisher's version: https://doi.org/10.1186/cc3888

Actions (login required)

Edit Item Edit Item